Dr Oday Rafoka

Springwood Family Practice

16 Ferguson Rd

Springwood

NSW 2777

30.03.25

Re: Alice Bauerhuit (DOB: 01/06/2005) NBM10953 review

Dear Dr Rafoka,

Thank you for referring Alice Bauerhuit to see me in July, 2024 for chronic severe anxiety and depression, under a GP MHCP, followed by a Wentworth Healthcare PTS plan. I write to provide you with an update and to let you know that her referral has been closed.

See previous correspondence for a comprehensive mental health assessment.

Initial Presentation

At the time of her initial consultation in July 2024, Alice opened up about her current life challenges. She reported multiple bereavements in past 10 years, including the unexpected death of her father 9 months prior while on a 3/12 work trip in the USA. His cause of death was unknown. She was very close with her father. Alice stated that she hasn't processed the loss and is aware that she has suppressed the grief, rather than allow emotions to externalise. This has been a pattern of dealing with emotional experiences throughout her life, and one she considers is across all family members.

Alice identified stressors/triggers for her emotional distress as the series of bereavements, as well as unhealthy relationships in her early teens. Her response pattern to heightened emotions is to avoid and shut down, instead of expressing, which results in pent up feelings which can then come out at unexpected times. Alice spoke of exhaustion and her emotional dysregulation when her “cup is too full.” She reported panic attacks, with increased heart rate, shaking, nausea and sobbing.

Due to her level of anxiety in the initial session, we agreed to explore things slowly over time (trauma informed care principles).

Alice works as a nurse in aged care, mostly on night shift.

Update

I last saw Alice on the 6th of December, 2024. At that time, she had moved in with her partner, Brayden, which had made a significant improvement to her emotional wellbeing. She missed a couple of appointments around that time, which she attributed to being busy. I followed up again in February, 2025 and left messages for Alice, however she did not return the calls or reply to the messages. I then contacted Brayden, her emergency contact, who reported that every thing was going very well. I again followed up with Alice last week, however she again did not reply. Given the feedback from Brayden, I am assuming it is because she is doing well and no longer needs psychological support.

Plan

I have closed Alice’s PTS referral due to lack of contact. Should she require further support at another time, I would be happy to see her.

Yours sincerely,

Michelle Hookham